Addressing Cardiac Conductive Disturbances Following TAVI Procedures: Optimizing Post-Procedure Care

Cardiac conduction disturbances (CDs) are a prevalent complication of transcatheter aortic valve implantation (TAVI) procedures, which are performed by interventional cardiologists to treat heavily calcified aortic valves. CDs may emerge during or after TAVI, and are typically caused by mechanical injury to the heart’s conduction system, which can be highly challenging to prevent during the procedure. Post-TAVI, patients may either receive a permanent or temporary pacemaker depending on their level of risk. Patients at high risk may receive a permanent pacemaker (PPM), however studies have shown that PPM dependency rates 30 days after TAVI range from 35% to 44%, highlighting a substantial subset of patients who may have received an unnecessary PPM. Conversely, patients with uncertain risk may be given a temporary pacemaker for further monitoring in the ICU, leading to an extended hospital stay and placing an additional financial burden on the healthcare system. Furthermore, around 2% of patients develop late-onset CDs after their in-hospital post-operative monitoring, yielding to future rehospitalization. To address this, we are developing a new form of pacing that is both temporary and ambulatory, allowing patients to safely return to their daily activities without the need for extended hospital stays and reducing unnecessary PPM implantations.

Faculty Supervisor:

Brian Courtney

Student:

Partner:

Sunnybrook Research Institute

Discipline:

Life Sciences

Sector:

Health and Related Sciences & Technology

University:

University of Toronto

Program: